Ticks may transmit numerous other diseases to people and pets. And, although they are less common than Lyme disease, it is no less important to protect yourself when in tick habitats. Ticks can be infected with other bacteria, viruses, or parasites, which are referred to as co-infections. You may not get any of these from a tick bite, or you may be infected with more than one illness from one tick bite. Other tick-borne infections can have similar symptoms to Lyme disease, so these infections may go undiagnosed and contribute to ongoing illness, even after receiving treatment for Lyme. Co-infections that may occur with a tick bite include:

Alpha-Gal Syndrome (AGS) may be acquired in North America after the bite of the Lone Star or the Blacklegged tick and is an allergy rather than an infection. Scientifically known as galactose-α-1,3-galactose. An allergy to this sugar molecule produces a delayed anaphylaxis reaction when red meat, milk or products made from non-primate mammals (animals with hooves, such as cows, pigs, deer, goats, etc) is ingested. Interestingly, it is not uncommon for this allergen to be triggered or worsened when combined with exercise, alcohol intake or when the meat eaten is especially fatty. Reactions can take from 2 to 12 hours before appearing and range from mild (itching, hives) to severe (IBS, seizures, and worse) and everything in between. Currently the only treatment for AGS is avoidance of the allergen although antihistamines and similar measures often help to moderate the reaction. At a minimum, this means not eating meat, gelatin, cheese, and other milk products (note: poultry and fish do not contain the alpha-gal molecule, they are safe to eat). For those with an extreme sensitivity to food additives, inactive or active ingredients in pharmaceuticals and medical products may also require caution (i.e. carrageenan, confectioners icing/shellac, gut sutures, etc). Diagnosis is typically done using a blood test ordered by a doctor. However, AGS is a relatively new condition. Even newer is the blood test for it, thus, your doctor may not yet be familiar with it. Currently there are 34,000 Americans diagnosed with alpha-gal, up from a few dozen known cases 16 years ago (2006) when researchers first started noticing an allergy to the alpha-gal molecule.

Anaplasmosis is a tick-borne disease caused by the bacterium Anaplasma phagocytophilum. It was previously known as human granulocytic ehrlichiosis (HGE) and has more recently been called human granulocytic anaplasmosis (HGA). Anaplasmosis is transmitted to humans by tick bites primarily from the black-legged tick (Ixodes scapularis) and the western black-legged tick (Ixodes pacificus). Of the four distinct phases in the tick life-cycle (egg, larvae, nymph, adult), nymphal and adult ticks are most frequently associated with transmission of anaplasmosis to humans. Typical symptoms include: fever, headache, chills, and muscle aches. Usually, these symptoms occur within 1-2 weeks of a tick bite. Anaplasmosis is initially diagnosed based on symptoms and clinical presentation, and later confirmed by the use of specialized laboratory tests.

Babesiosis is a malaria-like, parasitic infection that infects red blood cells and are spread by the bite of the Ixodes tick (black-legged tick). Most human cases of Babesia infection in the United States are caused by the parasite Babesia microti. Occasional cases caused by other species (types) of Babesia have been detected. Babesia microti is spread in nature by Ixodes scapularis ticks (also called black-legged ticks or deer ticks). The symptoms of Babesiosis normally begin about a week after a tick bite with a gradual onset of malaise, anorexia and fatigue. This is followed several days later by high fever, drenching sweats, muscle pain and headaches. As with malaria, these symptoms can continue over a protracted period or can abate, then recur. Babesia infection can range in severity from asymptomatic to life-threatening.

Bartonellosis (Cat Scratch Disease), first recognized in 1990, is an infection caused in North America by the Bartonella henselae bacteria. The illness has a number of vectors, including body lice, sand fleas, and animals carrying infected fleas (i.e. cats). In addition there is emerging data, although still controversial, suggesting ticks are also able to pass on this bacteria as well as a possible transmission route from mother to unborn child. The severity of a Bartonella infection varies from mild to severe and from short to long term. Because the bacteria tend to settle inside the lining of blood vessels it causes a host of different often baffling symptoms. The more unusual symptoms include: poor appetite, a streaked rash across the abdomen, blurred vision, balance problems, tremors and lymphoma. Furthermore, it can present with a neuropsychiatric component mimicking various psychiatric illnesses and greatly complicating recovery as patients may be steered away from a bacterial diagnosis for some time.

Borrelia miyamotoi is a tick transmitted bacteria that causes a type of relapsing fever in humans. The blacklegged tick (aka the deer tick) and the Western blacklegged tick are both known to carry this bacteria. A relatively new illness B. miyamotoi is spreading rapidly. It was first seen in Japan in 1995, in the United States by 2013 and currently in Canada from coast to coast. Most commonly this infection presents with flu-like symptoms including a fever (often re-occurring), chills, headaches, muscle aches and joint pain. In rare cases B. Miyamotoi targets the brain and central nervous system causing a far more severe illness (i.e. meningoencephalitis). There is a widely available diagnostic PCR test your physician can use to diagnose this particular tick-borne illness. It is of note that the bite from an infected tick with B. miyamotoi does not usually present with a rash. It is of further note that these two ticks live on the ground, in brush or leaf piles and attach to you as you pass by or handle the material. In particular, gardeners and homeowners are at increased risk if they handle the composting leaf mulch without proper tick protection.

Ehrlichiosis is the general name used to describe several bacterial diseases that affect animals and humans. Human ehrlichiosis is a disease caused by at least three different ehrlichial species in the United States: Ehrlichia chaffeensis, Ehrlichia ewingii, and a third Ehrlichia species provisionally called Ehrlichia muris-like (EML). Ehrlichiae are transmitted to humans by the bite of an infected tick. The lone star tick (Amblyomma americanum) is the primary vector of both Ehrlichia chaffeensis and Ehrlichia ewingii in the United States. Typical symptoms include: fever, headache, fatigue, and muscle aches. Usually, these symptoms occur within 1-2 weeks following a tick bite. Ehrlichiosis is diagnosed based on symptoms, clinical presentation, and later confirmed with specialized laboratory tests.

Powassan is a virus acquired by the bite of a blacklegged deer tick. This co-infection has long been considered rare, however current research shows that 17% of those who tested positive for Lyme also had Powassan. While infections have been found from California to Nova Scotia this virus is primarily found in the larger Great Lakes region and in the northeast. Once infected the virus may take two very different paths. Powassan produces no symptoms for many people but for others, the infection has a delayed start, then an initial set of symptoms followed by a second set of symptoms. Initial symptoms take from 1 to 4 weeks to appear and include fever, headache, vomiting and weakness. If the virus progresses it produces a severe and often life-threatening infection of the brain (encephalitis) or spinal cord (meningitis) which may display as confusion and memory difficulties, loss of coordination and muscle strength, difficulty speaking, seizures, and/or paralysis. Unfortunately, there are no known medications to treat this severe viral infection. Additionally, it has been estimated that half of those who survive a severe infection of Powassan are left with some level of permanent neurological damage.

Rocky Mountain spotted fever (RMSF) is a tick-borne disease caused by the bacterium Rickettsia rickettsii. This organism is a cause of potentially fatal human illness in North and South America, and is transmitted to humans by the bite of infected tick species. In the United States, these include the American dog tick (Dermacentor variabilis), Rocky Mountain wood tick (Dermacentor andersoni), and brown dog tick (Rhipicephalus sanguineus). Typical symptoms include: fever, headache, abdominal pain, vomiting, and muscle pain. A rash may also develop, but is often absent in the first few days, and in some patients, never develops. Rocky Mountain spotted fever can be a severe or even fatal illness if not treated in the first few days of symptoms. The initial diagnosis is made based on clinical signs and symptoms, medical history, can later be confirmed by using specialized laboratory tests.

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